| NPI | 1407550528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MICHAEL MCMAHON Pharmacy Manager 877-241-9002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2024-01-02 |